All new traditional students (commuters or on campus) must submit this form to complete your admissions file. In addition, students must submit their $100 enrollment deposit and Health Information Form and Shot record (Including Bacterial Meningitis) in order to have a housing assignment made.

Note: Fields marked with * are required.

*Select the term and year you plan to enroll at ETBU: *Year:


*First Name: *Middle Initial: *Last Name:

*Phone Number: Cell Phone:

*Social Security Number: *Sex :


*City: *State: *Zip:

*Birthdate: ,

*I will enter ETBU as a:
  ¹If transferring from another school:

    Last college attended?

    How many hours will you have completed when you enroll at ETBU?

Parent or Guardian Information:

*First Name: *Last Name:


*City: *State: *Zip:

*Parent Email: Cell Phone:

*Home Phone: Work Phone:


*Select One:
 I am applying for traditional undergraduate student housing on campus (under the age of 24).
 Complete Section B below.
I am applying for graduate or non-traditional (age 24 and over) student housing on campus. Limited housing available.
I am applying for married or single parent housing on campus. Limited housing available.
 I am under the age of 24 and plan to commute to ETBU and live off campus.
 Complete Section A below.
I am 24 or older and will be living off campus.

SECTION A If applying for on-campus housing, skip this section and complete Section B below.

*Select One

 I request permission to live at home with my parent. (If approved, you will receive notification granting you permission to live off campus.)

 I am independent based on the FAFSA criteria and request permission to live off campus. (This must be verified by the Financial Aid Office.)

 I am between the ages of 21 and 23 and request to live off campus and will not be living with a parent. I understand that I am not eligible for ETBU scholarships.

SECTION B Only fill out this section if you are planning on living on campus.

All first-year freshmen will have preferred housing in Centennial Hall. Once Centennial Hall is full, first year students will be housed in our upperclassment halls.

Transfer, Re-Enter and Graduate students will be placed in one of our upperclassmen residence halls. If you have a preference, pleas list it here:

*Do you have a specific student(s) you would like to request for your roommate(s)?
     Name of requested roommate:    He/She is a:  current student new student

     Name of requested roommate:    He/She is a:  current student new student

     Name of requested roommate:    He/She is a:  current student new student

(PLEASE NOTE: A full Housing Application for all roommates must be submitted by the May 1 deadline to garantee your requests.)

Meal Plan: All entering students will be billed for a full meal plan. Meal plan changes may be requested in the first few weeks of the semester in Student Affiarts, if you so choose.

In order to help us select a roommate best suited for you, please fill out the information below:

*Which best describes your style of housekeeping?

*Which types of music do you prefer to listen to?

*Which best describes your sleep habits?
Bed early/rise early
Bed late/rise late
Bed late/early rise
Bed early/rise late

*When do you prefer to study?
Morning (9am-12pm)
Afternoon (1pm to 5pm)
Evening (6pm to 10 pm)
Late (10pm - ?)

*What qualities do you feel are most important in a roommate:

*Personal Hobbies/Interests

Intended Major           Intended Minor (if Applicable)

In my family, I am the: Only Child   Oldest   Middle   Youngest

*How many siblings do you have?

*Do you plan to be be part of an ETBU athletic team or Organization?
If so, which one:

Would you be open to broadening your multi-cultural experience by having an international student as your roommate?

*Provide any additional comments that would help us place you with a roommate:

*Special Needs:
The ETBU Division of Student Affairs is committed to providing the highest degree of service to students. In an effort to assist you, prior to your arrival on campus, please share any information regarding special needs or concerns that you may have, such as: physically challenged, mental disorders, special medical needs, etc.

I understand that there are expectations to community living at East Texas Baptist University and I agree to read, understand and abide by all rules as outlined in the University Catalog and Student Handbook.